|
OB/GYN Editorial April 2003
Congratulations Vivian and Is The Media Tinged?
Thomas E. Nolan, MD, MBA
First, I would like to congratulate Vivian Dickerson,
MD, one of our associate editorial board members, in achieving
presidency of the American College of OB/GYNs. For many years,
Vivian has worked very hard for the College on women’s health
care issues. I first became aware of Vivian’s interest in
women’s health care when I published an editorial, the subject
of which she severely disagreed. Not being a great fan of alternative
medicine and therapies, Dr Dickerson wrote a very poign-ant letter
to me that we published in The Female Patient. Knowing that
diversity of opinion is an important part of the editorial process,
I asked Vivian to join our editorial board. Since then, she has
given us a very unique and insightful view of different areas of
OB/GYN that are not thought on by many "mainstream" practitioners.
Therefore, I think this is a tremendous achievement by Vivian and
that the American College of OB/GYNs should be commended in this
excellent choice.
As I write this editorial, the recent transplant
debacle at Duke Univer-sity has become a major news story in the
United States. As usual, a tremendous amount of coverage was given,
and many questions were asked about the appropriateness of the
way the mistake was handled and how the information was released
to the media. The family actually questioned how Duke University
hospital handled the tragedy, and said they (the hospital) should
have come forward and made a national news release of what I consider
to be a personal and local problem. This was in the interest of
receiving other organs sooner for a second transplant. Soon after
the second transplant, the patient was declared brain dead. More
questions were fielded on the appropriateness of when life support
should be removed. Most states that participate in donor pools
have these laws to help make this decision easier for the family.
Even though these laws have been in place for more than 2 decades,
the media has now jumped on these laws. The media is jumping into
multiple issues without going through further investigation.
Recently, I read an article in the March 3, 2003,
edition of Fortune (pg 110) that addressed how doctors were
beginning to turn the tide on the medical malpractice and tort
reform issue. It’s been the first article I have found that
supports how physicians are making some headway into this abysmal
problem. However, when I watch other aspects of the way the media
responds to medical issues, I become extremely dismayed. The report
on the number of medical errors in the United States that came
out several years ago has been widely disseminated in the media,
making an error a newsworthy event. Even though there were questions
about the paper and the methodology of gathering these data, it
has become almost chiseled in stone that medical errors cause a
tremendous amount of morbidity in the United States. The media
knows they have a sacrificial lamb they can pull out whenever they
want. I’ve been dismayed to see on various morning shows,
including Today on NBC, that patients who have had medical
errors due to hospital or physician error are now getting all the
press time they need. Granted, while these cases represent very
serious breaches in care (one was an unnecessary removal of breast
for a cancer that did not exist; the other was a case of a surgical
instrument left in a large woman), both individuals were accompanied
by their attorneys! Why the popular press allows plaintiff attorneys
to go on the air and essentially press their cases against tort
reform boggles my mind. In many cases, the physicians are not queried
or have refused to be identified.
Additionally, it does not help our cause when
we have problems such as the physician who graduated from the University
of Kentucky and then decided to "brand" uteri prior to
removing them, later trying to justify this. The justification
that this helps to identify the side of the uterus during the surgery
just does not cut it. With all the problems we have with tort reform,
this really makes us look rather foolish and insensitive.
Another important aspect of tort reform is the
issue that we need to work not only for our own issues, but with
the business community. Practicing in the Deep South has multiple
barriers to care. Widespread poverty is due to multiple factors,
and a primary reason not to relocate to Mississippi is the poor
business atmosphere. Why would a manufacturer want to come to a
state that continually runs off corporations with unnecessary litigation.
These cases have a horrible effect on entering industries that
know whatever trade-off they would get in tax breaks would be nullified
by easily swayed juries in rural areas resulting in awarding large
payments. The physicians must not think they are the only ones
carrying the burden of torts, but also various businesses in the
United States. Even though the recent case of the obesity versus
McDonald’s lawsuit was dismissed, the judge’s opinion
spelled out how the case could be re-filed to his satisfaction.
More and more we are becoming paralyzed as a society
because of the legal ramifications for all of our actions. Unfortunately,
my experience with attorneys is that they’re not always the
brightest bulbs in the lot, nor are they individuals whom I consider
to have the best interest of anyone but themselves at heart. I
recently received a letter from someone who read my editorials,
and told me that an individual whom I had briefly known in the
past was retiring because of medical malpractice reasons. Many
very successful physicians hitting the magic age of retirement
of 60 to 62 years are now calling it quits. My biggest current
concern is that the number of practitioners we have available may
be severely limited, so that when the crisis does finally resolve,
the number of physicians offering health care to women may be limited.
I may be overstating my case. I understand that.
However, my overall impression of the person power needs for women’s
health care is going to be severely compromised by ongoing malpractice.
Your concerns or comments are, as always, welcomed.
Sincerely,
Thomas E. Nolan, MD, MBA
back to top
|
